Oligoarticular juvenile idiopathic arthritis — SCE Rheumatology MCQ

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HardPaediatric rheumatologyOligoarticular juvenile idiopathic arthritisSCE Rheumatology

A patient with relapsing PR3-ANCA granulomatosis with polyangiitis is in remission after rituximab induction. Fixed-schedule rituximab maintenance is selected. Which dosing range matches BSR 2025?

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Correct answer: B — Rituximab 500–1000 mg every 4–6 months

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · C = shown as D

A is correct. BSR recommends a fixed rituximab maintenance range of 500–1000 mg every four to six months. Fixed dosing is preferred over waiting for symptoms, and evidence suggests ANCA-guided retreatment alone can allow more relapse. The weekly 375 mg/m² and two-dose 1 g patterns are induction approaches, not the maintenance schedule stated here. Dose, interval and total duration are individualised around relapse risk, prior organ damage, infections, immunoglobulins and vaccine planning.

Reference: BSR 2025 management recommendations for ANCA-associated vasculitis: https://pmc.ncbi.nlm.nih.gov/articles/PMC12316377/